Paper short abstract:

This paper reflects on conflicts that have emerged whilst undertaking anthropological research alongside colleagues seeking to control the spread of tropical diseases in East Africa. It highlights the challenges of 'speaking truth to power' noting the benefits & counter-productive consequences.

Paper long abstract:

This paper reflects on conflicts that have emerged in the course of doing anthropological research alongside colleagues seeking to control the spread of neglected tropical diseases in East Africa. Drawing upon fieldwork undertaken at numerous locations in Uganda and Tanzania since 2005, the paper analyses responses to our research on three tropical diseases: schistosomiasis, lymphatic filariasis and soil-transmitted helminths. This research suggests that current strategies to distribute drugs free of charge to adults and children living in endemic areas is less effective than that indicated in the biomedical literature and, at several sites, has failed. The process of researching and writing up field research has elicited a range of responses from parasitologists, epidemiologists, vector biologists and public health specialists involved in the implementation and/or monitoring of the control programmes. This has included attempts to restrict access to field sites, to contain the dissemination of findings, to re-do local studies in such a way as to suggest that drug coverage is higher than it is, to hold back information suggesting rates of re-infection are high in the aftermath of treatment, the exertion of moral pressure to set aside information that may threaten funding and livelihoods, and misrepresentation of our research in refereed medical journals in an effort to discredit it. The paper highlights the challenges of 'speaking truth to power' in a context where control programmes are primarily funded by international organisations such as the Gates Foundation, USAID, and the UK DfID, and it notes the benefits of doing so as well as the counter-productive consequences.